Endoscopic ultrasound-guided biliary drainage vs percutaneous transhepatic biliary drainage for malignant biliary obstruction after endoscopic retrograde cholangiopancreatography failure

He Zhao; Xiao-Wu Zhang; Peng Song; Xiao Li

doi:10.4240/wjgs.v16.i11.3614

Endoscopic ultrasound-guided biliary drainage vs percutaneous transhepatic biliary drainage for malignant biliary obstruction after endoscopic retrograde cholangiopancreatography failure

World J Gastrointest Surg. 2024 Nov 27;16(11):3614-3617. doi: 10.4240/wjgs.v16.i11.3614.

Authors

He Zhao¹, Xiao-Wu Zhang², Peng Song³, Xiao Li²

Affiliations

¹ Department of Interventional Therapy, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China. hezhaoo@gmail.com.
² Department of Interventional Therapy, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
³ Department of Interventional Therapy, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen Hospital, Shenzhen 518000, Guangdong Province, China.

Abstract

In a recent issue of the World Journal of Gastrointestinal Surgery, a meta-analysis investigated the safety and efficacy of electrocautery-enhanced lumen-apposing metal stent (ECE-LAMS) implantation for managing malignant biliary obstruction following failed endoscopic retrograde cholangiopancreatography. This manuscript endeavors to offer a comprehensive look at the progression of endoscopic ultrasound-guided biliary drainage (EUS-BD) technologies, weighing their merits and drawbacks against traditional percutaneous methods. Several meta-analyses and randomized controlled trials have compared the performance of EUS-BD and percutaneous transhepatic cholangiodrainage (PTCD). These studies revealed that the technical success rate, clinical success rate, and adverse events were similar between EUS-BD and PTCD. Nevertheless, given that most of these studies predate 2015, the safety and effectiveness of novel EUS-BD techniques, including ECE-LAMS, compared with those of percutaneous biliary drainage remain elusive. Further investigation is imperative to ascertain whether these novel EUS-BD techniques can safely and efficaciously replace conventional percutaneous therapeutic approaches.

Keywords: Biliary drainage; Endoscopic retrograde cholangiopancreatography; Endoscopic ultrasound; Malignant biliary obstruction; Percutaneous transhepatic biliary drainage.